As someone brought up by parents interested in alternative medicine, I’ve spent much of my life in flight from it — refusing to believe anything medical if it hasn’t been said to me by a doctor in surgical scrubs and surrounded by gleaming stainless-steel instruments. Recently, when researching a 16th-century novel, I found myself fascinated by how far modern conventional medicine has come. Below, I chart the differences — and some similarities — between then and now.

DOCTORS

In the 1530s, there were three types of medics. Gentlemen physicians offered learned, rational or astrological explanations for illness. They provided herbal remedies (provided by apothecaries or herbalists) in the form of purgatives (suppositories), clysters (enemas) and pills, sometimes coated with gold to make them work better — for “inward” ailments. Surgeons were lowly tradesmen,who set bones, amputated limbs and performed the only operation on internal organs they then knew — the removal of kidney and bladder stones. Finally, midwives were licensed by the Church and had the duty not just to deliver babies but to persuade mothers to divulge the names of the fathers, so the latter could be encouraged by the parish to marry.

THEORY

Unlike today’s practice-oriented treatments, medicine in the 16th century was based on a single all-encompassing theory: the notion that health depended on balancing the four humours — or liquids — in the body, which were thought to correspond to the four elements — fire, air, water and earth. The liquids were blood (the source of vitality), phlegm (colourless body secretions from semen to sweat to tears — a lubricant and cooler), choler (or yellow bile, the gastric juice) and black bile (or melancholy, a dark liquid never found pure but which was reckoned responsible for darkening other fluids). Blood made the body hot and wet, choler hot and dry, phlegm cold and wet, and black bile cold and dry.

Illness was said to occur when one humour was retained in excess — “becoming plethoric” — or putrefied. The clerk Bartholomai Sastrowen remembered that his father was “rather rash” and “when the choler got the upper hand, he could not control himself”.

PREVENTION

Treatment of an illness consisted of analysing a patient’s urine to decide which humour dominated. Remedies would then be prescribed to rebalance the body by siphoning off whichever fluid was corrupted or in excess, whether through bleeding or purging or vomiting.

There were two Classical models for prescribing antidotes — the Greek Hippocrates advocated conservative cures such as waiting and watching, bed-rest, tonics, care, calm and hope; and Galen, a self-publicist from Roman times, preferred violent purges or drastic blood-letting. The rich employed physicians on a permanent basis to offer detailed advice, such as avoiding the food of the poor and to go horse-riding, which was more beneficial than the sweaty labour of the peasantry.

CURES

Many diseases of the 16th century were caused by the curses of poverty — dirt, bad hygiene and malnutrition. These reduced resistance to the epidemics of syphilis, smallpox and tuberculosis brought to medieval England by war and travel. The modern diseases of affluence — from obesity to cancers brought on by overindulgence in alcohol or tobacco — were little known.

Syphilis was thought to have come to Europe with Columbus after his return from America. The acute form that afflicted early sufferers ate away noses and genitals, twisted limbs, and often killed in its early stages.

In the 16th-century William Clowes wrote in De Morbo Gallico that “this pestilent infection of filthy lust” which “increaseth daily” could be cured by: (1) perfect amendment of life (2) punishment and (3) submitting to Clowes’s cure, based on mercury. Patients were shut in a “stew”, a small steam room, for 20 or 30 days at a time. They were coated from head to foot in a mercury-based ointment, swathed in blankets, and left until the sweat poured down. Disgusting secretions issued from their mouths and noses; sores filled their throats, tongues, cheeks, lips and the roofs of their mouths. Their jaws swelled and often their teeth fell out.